My gf is currently on this med and is not allowed milk thistle due to it's counter effects what would be the best option for her
Hello and thanks for posting.
Your question relates to drug-drug interactions between HIV medications and alternative treatments. Some HIV medications have significant drug-drug interactions, especially those, like Genvoya that require the use of pharmacologic boosters (in the case of Genvoya, the drug cobicistat).
But wait. Your GF is on an evidence-based, recommended initial treatment for HIV (Genvoya), yet asking about changing the medication because she wants to take milk thistle?
According to the US National Center for Complementary and Integrative Health,
"two rigorously designed studies found no (health) benefit".
Accordingly, I do not recommend that patients take milk thistle.
If your question is how to best maintain liver health, as is often purported by the folks who sell milk thistle, it's best to stick to the proven: avoid excess alcohol (or if one is living with chronic hepatitis virus, avoid alcohol completely); get tested and immunized against hepatitis A and B virus, and if living with hepatitis C virus, get cured. For people living with HIV, get on and stay adherent to ART medications and get recommended and periodic clinical and laboratory monitoring.
The rest I'd file under the heading of snake oil.